Trans Women and HIV: Social Psychological Perspectives PDF
Preview Trans Women and HIV: Social Psychological Perspectives
Trans Women and HIV Social Psychological Perspectives Trans Women and HIV “In the face of high levels of stigmatisation and prejudice against trans people, thisbookoffersanimportantcontributiontoknowledge.Ittakesanuancedand insightfulapproachtoaneglectedarea—transwomenandHIV—anditwillbeof interesttopractitioners,policymakers,andthosewhoareconcernedwithhealth, sexuality, and gender.” —Prof. Surya Monro, University of Huddersfield, UK “As a psychological practitioner providing clinical education and training to the next generation of mental health workers, I believe that this timely and relevant bookhighlightstheimportanceofunderstandingthephenomenologicalperspec- tive of sexual and ethnic diversity in the medical and psychiatric models. The case studies bring to life the people behind the labels, integrating the context and theoretical foundations to provide an empathic, resilience-based model to promote psycho-medical well-being interventions. This book also offers a way forward with recommendations for policy makers and programme developers managing health risks and health promotion.” —Dr. Joann Griffith, De Montfort University, Leicester, UK “Trans women living with HIV may be uncounted in datasets. This book details exquisitely the complex intersectional aspects of stigma faced by this group, exposing its structurally violent and disempowering nature. Jaspal notes the struggle to construct an identity characterised by “self-esteem, continuity, belongingandauthenticity”,compoundedbyHIVstatus,andthecopingmech- anisms that may be adopted to deal with transphobia, sexism and racism. It is a powerful and essential work, and for clinicians offers important, practical recom- mendations that we must strive better to embed into HIV care and prevention services. We are left with a key question needing urgent attention—how can we all discourage concealment and self-isolation among trans women living with HIV, to reduce stigma, and improve health overall?” —Dr. Tristan J. Barber, Royal Free Hospital, London, UK Rusi Jaspal Trans Women and HIV Social Psychological Perspectives Rusi Jaspal School of Social Sciences Nottingham Trent University Nottingham, UK ISBN 978-3-030-57544-1 ISBN 978-3-030-57545-8 (eBook) https://doi.org/10.1007/978-3-030-57545-8 © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2020 This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval,electronicadaptation,computersoftware,orbysimilarordissimilarmethodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such namesareexemptfromtherelevantprotectivelawsandregulationsandthereforefreefor general use. Thepublisher,theauthorsandtheeditorsaresafetoassumethattheadviceandinforma- tion in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respecttothematerialcontainedhereinorforanyerrorsoromissionsthatmayhavebeen made.Thepublisherremainsneutralwithregardtojurisdictionalclaimsinpublishedmaps and institutional affiliations. Cover illustration: © Melisa Hasan This Palgrave Macmillan imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland Acknowledgements My research career has seen me explore aspects of identity, relation- ships and psychological wellbeing in many minority groups in society. Throughout all of these research projects, I have always been motivated by the same things: my deep appreciation of diversity, which enriches our society; my fascination with the functioning of social groups; and my conviction that diversity must be supported so that minority groups can thrive and flourish. Outgroups have a crucial role to play in enabling minority groups to experience social and psychological wellbeing. It has felt very rewarding to write this book about transgender women living withHIVintheUK.Thebookbeginstofillagapthatmanyofusinthe field of HIV have long lamented. I am immensely grateful to the eleven trans women who generously shared their experiences with me. I thank my Ph.D. students over the years whose ideas have inspired me. I would like to express my deepest gratitude to Aedan J Wolton without whose supportthisprojectwouldsimplynothavecometofruition.Iamgrateful toLaurenKennedywhowasmyresearchassistantontheEXTRA(Experi- encesofTransWomenLivingWithHIV)StudyandtoSueHaywardwho provided excellent administrative support. I thank my beloved family— Ramesh, Asha, Babak and Jaya—for their unwavering support during the writing of this and other books. v Contents Part I Trans Women in Context 1 Understanding Trans Women and HIV 3 2 The Construction of Trans Identity 25 3 HIV Stressors and Risk Factors 43 Part II Trans Women Living with HIV in the UK 4 Researching HIV and Trans Women 67 5 Multi-Layered Stigma 89 6 Self-Isolation and Identity Concealment 109 vii viii CONTENTS 7 Sex Work and HIV 127 Part III Conclusion 8 Supporting Trans Women Living with HIV 147 Index 155 List of Figures Fig. 1.1 Number of HIV diagnoses by year in the United Kingdom (2004–2018) 19 Fig. 2.1 Identity process theory (from Jaspal, 2018) 31 Fig. 3.1 The Health Adversity Risk Model (from Jaspal et al., 2018) 55 ix PART I Trans Women in Context CHAPTER 1 Understanding Trans Women and HIV Abstract In this introductory chapter, the social psychological focus of the volume on the experiences, identities and psychological well-being of trans women living with HIV in the UK is discussed. The key questions addressed in this volume are described: (1) How do trans women living with HIV experience their diagnosis and the ‘stressors’ associated with thecondition?(2)HowdotheyperceiveandmanageHIVdisclosure?(3) How does the experience of living with HIV shape identity and psycho- logical well-being among trans women? Two case studies are provided to illustrate the psychological challenges among trans women living with HIV in the UK. Key terms that are used in the volume are defined. A brief history of trans women and a brief overview of key statistics on the trans population and of HIV incidence in the UK are provided. Keywords HIV · Trans women · Trans history · HIV epidemiology · Social psychology Thefieldofhumanimmunodeficiencyvirus(HIV)hasundergonesignifi- cantdevelopmentsincethefirstclinicalobservationsofacquiredimmune deficiencysyndrome(AIDS)in1981.HIVhasgonefrombeinganalmost invariablylife-limitingdiseasetoalife-changingchroniccondition.Effec- tive treatments have been developed, ensuring a very good prognosis for those diagnosed and treated early. Both the efficacy and tolerability of © The Author(s) 2020 3 R. Jaspal, Trans Women and HIV, https://doi.org/10.1007/978-3-030-57545-8_1
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